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Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants.

Abstract

BACKGROUND

3-Hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors reduce serum cholesterol and are increasingly advocated in primary prevention to achieve reductions in LDL cholesterol. Newer dietary approaches combining cholesterol-lowering foods may offer another option, but these approaches have not been compared directly with statins in the same persons.

OBJECTIVE

The objective was to compare, in the same subjects, the cholesterol-lowering potential of a dietary portfolio with that of a statin.

DESIGN

Thirty-four hyperlipidemic participants underwent all three 1-mo treatments in random order as outpatients: a very-low-saturated-fat diet (control diet), the same diet plus 20 mg lovastatin (statin diet), and a diet high in plant sterols (1.0 g/1000 kcal), soy-protein foods (including soy milks and soy burgers, 21.4 g/1000 kcal), almonds (14 g/1000 kcal), and viscous fibers from oats, barley, psyllium, and the vegetables okra and eggplant (10 g/1000 kcal) (portfolio diets). Fasting blood samples were obtained at 0, 2, and 4 wk.

RESULTS

LDL-cholesterol concentrations decreased by 8.5+/-1.9%, 33.3+/-1.9%, and 29.6+/-1.3% after 4 wk of the control, statin, and portfolio diets, respectively. Although the absolute difference between the statin and the portfolio treatments was significant at 4 wk (P=0.013), 9 participants (26%) achieved their lowest LDL-cholesterol concentrations with the portfolio diet. Moreover, the statin (n=27) and the portfolio (n=24) diets did not differ significantly (P=0.288) in their ability to reduce LDL cholesterol below the 3.4-mmol/L primary prevention cutoff.

CONCLUSIONS

Dietary combinations may not differ in potency from first-generation statins in achieving current lipid goals for primary prevention. They may, therefore, bridge the treatment gap between current therapeutic diets and newer statins.

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  • Authors+Show Affiliations

    ,

    Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, Canada. cyril.kendall@utoronto.ca

    , , , , , , , , , , , , ,

    Source

    MeSH

    Adult
    Aged
    Anticholesteremic Agents
    Cholesterol, Dietary
    Cholesterol, LDL
    Cross-Over Studies
    Dietary Fiber
    Drug Therapy, Combination
    Fasting
    Female
    Humans
    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Hyperlipidemias
    Lovastatin
    Male
    Middle Aged
    Phytosterols
    Primary Prevention
    Soybean Proteins
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15699225

    Citation

    Jenkins, David J A., et al. "Direct Comparison of a Dietary Portfolio of Cholesterol-lowering Foods With a Statin in Hypercholesterolemic Participants." The American Journal of Clinical Nutrition, vol. 81, no. 2, 2005, pp. 380-7.
    Jenkins DJ, Kendall CW, Marchie A, et al. Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants. Am J Clin Nutr. 2005;81(2):380-7.
    Jenkins, D. J., Kendall, C. W., Marchie, A., Faulkner, D. A., Wong, J. M., de Souza, R., ... Connelly, P. W. (2005). Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants. The American Journal of Clinical Nutrition, 81(2), pp. 380-7.
    Jenkins DJ, et al. Direct Comparison of a Dietary Portfolio of Cholesterol-lowering Foods With a Statin in Hypercholesterolemic Participants. Am J Clin Nutr. 2005;81(2):380-7. PubMed PMID: 15699225.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants. AU - Jenkins,David J A, AU - Kendall,Cyril W C, AU - Marchie,Augustine, AU - Faulkner,Dorothea A, AU - Wong,Julia M W, AU - de Souza,Russell, AU - Emam,Azadeh, AU - Parker,Tina L, AU - Vidgen,Edward, AU - Trautwein,Elke A, AU - Lapsley,Karen G, AU - Josse,Robert G, AU - Leiter,Lawrence A, AU - Singer,William, AU - Connelly,Philip W, PY - 2005/2/9/pubmed PY - 2005/3/9/medline PY - 2005/2/9/entrez SP - 380 EP - 7 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 81 IS - 2 N2 - BACKGROUND: 3-Hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors reduce serum cholesterol and are increasingly advocated in primary prevention to achieve reductions in LDL cholesterol. Newer dietary approaches combining cholesterol-lowering foods may offer another option, but these approaches have not been compared directly with statins in the same persons. OBJECTIVE: The objective was to compare, in the same subjects, the cholesterol-lowering potential of a dietary portfolio with that of a statin. DESIGN: Thirty-four hyperlipidemic participants underwent all three 1-mo treatments in random order as outpatients: a very-low-saturated-fat diet (control diet), the same diet plus 20 mg lovastatin (statin diet), and a diet high in plant sterols (1.0 g/1000 kcal), soy-protein foods (including soy milks and soy burgers, 21.4 g/1000 kcal), almonds (14 g/1000 kcal), and viscous fibers from oats, barley, psyllium, and the vegetables okra and eggplant (10 g/1000 kcal) (portfolio diets). Fasting blood samples were obtained at 0, 2, and 4 wk. RESULTS: LDL-cholesterol concentrations decreased by 8.5+/-1.9%, 33.3+/-1.9%, and 29.6+/-1.3% after 4 wk of the control, statin, and portfolio diets, respectively. Although the absolute difference between the statin and the portfolio treatments was significant at 4 wk (P=0.013), 9 participants (26%) achieved their lowest LDL-cholesterol concentrations with the portfolio diet. Moreover, the statin (n=27) and the portfolio (n=24) diets did not differ significantly (P=0.288) in their ability to reduce LDL cholesterol below the 3.4-mmol/L primary prevention cutoff. CONCLUSIONS: Dietary combinations may not differ in potency from first-generation statins in achieving current lipid goals for primary prevention. They may, therefore, bridge the treatment gap between current therapeutic diets and newer statins. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/15699225/Direct_comparison_of_a_dietary_portfolio_of_cholesterol_lowering_foods_with_a_statin_in_hypercholesterolemic_participants_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn.81.2.380 DB - PRIME DP - Unbound Medicine ER -